RVU Task Force report: does it really reflect the current methods of practice?
The ODA in a publication in December 1996 gave two reasons for commissioning this study. 13 First, over the years a number of anomalies had crept into the Fee Guide and needed to be addressed. For instance, code 14301 (motivation of a patient with a bad habit) had a higher responsibility than a root canal treatment code. The second reason was to keep the guide reflective of the current methods of practice of dentistry. These are very noble ideals and unfortunately they were not achieved with the publication of this report. I have provided a few examples of times and responsibility which are not in keeping with the current methods of practice of dentistry. Common sense along with the scientific literature bears this out. The report is filled with inaccuracies and anomalies. In numerous instances there are procedures with times that would not allow for the provision of quality care. One over riding concern is that only 100 procedures had their times directly measured and the remaining 1,100 procedures had their times extrapolated from these measured times. If any of these 100 measured times are inaccurate or do not reflect the current methods of practice, then the extrapolated times will also not be correct. The RVU Task Force has asked for input from the membership. Copies of the report were initially only distributed in limited numbers to the Dental Societies and not to the membership at large. The membership could request additional copies and was given three months to prepare and submit a response on prepared feedback forms. The Task Force received feedback from over 300 members. They now claim that this feedback has generated extensive changes in the diagnostic and restorative sections, recall packages, the endodontic section and fixed and removable prosthodontics. 14 There appears to have been major changes throughout the entire report. How can one then claim that the report was scientifically done or that it produced valid results? How are we sure that these 300 members actually reviewed each and every one of the times and "R" factors for all 1,200 procedures in the Fee Guide? Does this input from the membership now create a valid study? Do these subsequent changes alter the supposed "scientific" underpinning of the RVU Report? Are we sure that these changes will now create a document that meets the objectives of this study? Why should the membership have to review, critique and fix a report that had numerous glaring flaws from its outset? Why must the membership of the Ontario Dental Association and every practicing dentist in Ontario be subjected to the ramifications of this flawed and inaccurate report? The final report will be available prior to the General Council Meeting of the Ontario Dental Association in May 1997. I urge every member to read and review the entire report to see if it meets the objectives of the Task Force. From reviewing the Draft Final Report of the RVU Task Force, and the proposed changes, I would strongly urge all members of the General Council of the Ontario Dental Association to reject any implementation of this report.
Abrams
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D005245:Fee Schedules; D005250:Fees, Dental; D006801:Humans; D009864:Ontario; D011215:Practice Management, Dental / Q000639:trends*; D012953:Societies, Dental; D013996:Time and Motion Studies